Thank you for Sally Mauk’s article about Dr. Ira Byock and “dying well” (“Doctor says advances prolong life, make dying harder,” March 16). I write to comment on the reference to “whether physician-assisted suicide should be legalized.”

In Montana, proposals to legalize assisted suicide are not necessarily about people who are dying. For example, during the Baxter litigation, the plaintiffs proposed a definition of “terminally ill adult patient” that would have rendered young adults with treatable conditions such as diabetes and HIV/AIDS “eligible” for assisted suicide. See the opinion letter by Attorney Theresa Schrempp and Dr. Richard Wonderly at www.euthanasiaprevention.on.ca/ ConnMemo02.pdf.

Similarly, during our last legislative session, the failed bill, SB 167, defined eligibility for assisted suicide in terms of a doctor’s prediction of six months to live. Such predictions can be wrong. See for example, Nina Shapiro, “Terminal Uncertainty – Washington’s new ‘Death with Dignity’ law allows doctors to help people commit suicide – once they’ve determined that the patient has only six months to live. But what if they’re wrong?” at www.seattleweekly.com/ 2009-01-14/news/terminal-uncertainty.

Legalizing assisted suicide would, regardless, be a recipe for elder abuse. It would create multiple other problems. I invite all of your readers to look at our website, www.montanansagainstassistedsuicide.org.

If anyone would like to help keep assisted suicide out of Montana, please contact me to volunteer. Donations are also appreciated. Thank you!Bradley D. Williams, Coordinator, Montanans Against Assisted Suicide and For Living with Dignity, Hamilton

The death with dignity debate has been tabled and a state senator is in the hospital. The vice chair of the Senate Judiciary Committee, Sen. Alice Nitka, is currently in the hospital after an accident at her home Thursday. The committee was expected to vote on the controversial end of life bill Friday.

The bill would give terminally ill patients the right to end their own life. But instead of voting Friday, the chair met with Gov. Peter Shumlin to say the bill will not move.

This session marks the first hearing of the end of life bill in a Vermont Senate committee. But lawmakers say most of the work was done behind closed doors.

Reporter Susie Steimle: How much would you say politics have come into play here? Sen. Diane Snelling: Quite a bit.

"Oh yeah, there's been some strong pressure. But there's strong pressure on a lot of bills. But this is an emotional bill; it hits everyone," said Sen. Dick Sears, D-Bennington County.

Sears is holding his ground. He said the bill would not leave his committee this session. We now know that it won't.

As a seasoned senator with the president pro-tem on his side, much of the political pressure to keep this bill from moving came from him. On the other side it came from the governor, who supports the bill.

"When you're a good friend like I am with the governor, it's hard to tell when it's friendship and when it's pressure. But I know he's disappointed with the decision," Sears said.

The committee held extensive testimony this week, which drew hundreds of Vermonters from across the state.

Snelling, who supports the bill, says she fears this gave people false hope.

"I almost wish we hadn't taken testimony, which we did take, because in a sense that gets people to think something is going to happen," said Snelling, R-Chittenden County.

Snelling wanted to send this bill out of committee without recommendation, something Sears calls "wimpy."

"Saying we voted it out without recommendation is like saying we don't have the courage to stand up for what we believe," Sears said.

"I wish that this bill could come to the floor and I've heard from many people on both sides that it's a matter of conscience, in which case, let's vote on our conscience," Snelling said.

Snelling says at this point she's accepted defeat for this session, but that doesn't mean she's giving up.

"It's a difficult issue, I know it's a difficult issue, but I didn't come here to do easy things. So it's very important to stand on the strength of my convictions," Snelling said.

Both senators say it's likely some supporters of the end of life bill will try to attach it to the health care bill, which will be voted on later this session, but neither senator believes it will pass that way. Snelling says she expects it will be back next session.

Supporters don't know if there are enough votes to pass it in the Senate. It's extremely divided. I've heard the vote could be 16-14 either way, but part of the controversy here is this is truly a Senate battle; the House is ready to pass it and the governor supports it.

Monday, March 12, 2012

Today, Montanans Against Assisted Suicide & For Living with Dignity filed a request with the Montana Board of Medical Examiners to vacate its recent position statement, which misstates the Baxter decision and erroneously implies that assisted suicide is legal in Montana. This request is brought for the sake of public safety.

To view the cover letter by attorney Craig D. Charlton, click here. To view his legal memorandum, click here. To view the attachments to that memorandum, click here.

Attend the hearing at the State House next Tuesday, and oppose H.3884.

What: Hearing of the Joint Judiciary Committee on H. 3884 - an act to allow "Death with Dignity" in MA.When: Tuesday, March 6 at 1 p.m.Where: State House, Room A-2Why: This bill is dangerous for people with disabilities, elders and people with serious illness.Contact: Second Thoughts and John Kelly at (617) 536-5140

Second Thoughts is a group of Disability Rights Organizations and Activists who oppose this "Death with Dignity" ballot initiative. Here are some of the compelling reasons why this bill is dangerous.

Self-determination: Assisted suicide is unnecessary to have control because each person has the right to refuse lifesavingtreatment, and to have adequate pain relief, including palliative sedation. Assisted suicide decreases self-determination by giving doctors and insurers the power not just to cure, but to kill.

Abuse: The proposed law is a recipe for elder abuse. An heir can be a witness and help sign someone up, and once a lethal drug is in the home, no one will know how the drug is administered. If the person struggled, who would know?

No Safeguards:A lack of safeguards and oversight in the proposed law puts people at risk of misdiagnosis, deprivation of treatment and economic pressure to choose suicide, while protecting doctors from liability.

If a doctor refuses lethal drugs, the patient or family simply can--and do--find another doctor ("doctor shopping").

"Terminal condition" and "death within six months" are often misdiagnosed, opening the dangers of assisted suicide to many who are not terminally ill.

The law does not require that people are screened or treated for depression or other mental health conditions that cause suicidal feelings.

The law does not include enforcement provisions, investigation authority, oversight or data verification. The only foolproof safeguard is for the prescribing doctors. The law holds doctors to only a "good faith" standard, which makes any safeguards unenforceable.

Discrimination: A law that singles out some people (such as old, ill and disabled people) for assisted suicide instead of suicide prevention is no in step with Massachusetts' progressive tradition as a leader against discrimination.

Thursday, March 1, 2012

Proponents claim that legalizing assisted suicide will keep the government out of people's lives. The opposite is true.

Fact check: In Oregon, where assisted suicide is legal, legalization has allowed the Oregon Health Plan, a government entity, to steer people to suicide. The most well known cases involve Barbara Wagner and Randy Stroup. Each wanted treatment. The Plan denied coverage and steered them to suicide by offering to cover the cost of their suicides instead. See See Susan Donaldson James, "Death Drugs Cause Uproar in Oregon," ABC News, August 6, 2008; and "Letter noting assisted suicide raises questions," KATU TV, July 30, 2008.

2. The Initiative Allows Someone Else to Administer the Lethal Dose

Proponents claim that only the patient may administer the lethal dose. This is not true.

Fact check: The initiative (H.3884) states that patients "may" self-administer the lethal dose. There is no language stating that administration “must” be by self-administration. "Self-administer" is also a specially defined term that allows someone else to administer the lethal dose to the patient. See here.

3. An Heir is Allowed to Witness the Lethal Dose Request

Proponents claim that the lethal dose request form must be "independently witnessed" by two people. This is not true.

Fact check: The initiative, Sections 3 and 21, provides that one of two witnesses on the lethal dose request form cannot be a patient’s heir or other person who will benefit financially from the patient's death; the other witness can be an heir or other person who will benefit financially from the death.

4. Substantial Compliance

Proponents claim that the initiative has "strict safeguards" to protect patients. The initiative, however, only requires "substantial compliance" with its provisions. Section 18(1)(a) states: "A person who substantially complies in good faith with provisions of this chapter shall be deemed to be in compliance with this chapter."

5.Assisted Suicide is a Recipe for Elder Abuse

Proponents claim that the initiative is safe, which is not true.

Fact check: The initiative does not require witnesses at the death. Without disinterested witnesses, the opportunity is created for an heir, or someone else who will benefit financially from the death, to administer the lethal dose to the patient without the patient's consent. Even if he struggled, who would know?

6. Patients are not Necessarily Dying

Proponents imply that the initiative only applies to people in their "final days." This is untrue.

Proponents claim that people with disabilities are not at risk from legalization of assisted suicide, which is untrue.

Fact check: Disability rights groups such as Not Dead Yet oppose assisted suicide as a threat to their lives. In Oregon and Washington, official government forms for assisted suicide acts in those states promote disability as a reason to commit suicide.[1] People with disabilities are thereby devalued. In 2009, there was a proposed assisted suicide bill in New Hampshire that squarely applied to people with disabilities.[2] If the initiative were to be passed now, people with disabilities see themselves as potentially next in line under a future expansion of that law. As noted above, there has already been a proposal in Washington state to expand its law to direct euthanasia for non-terminal people.

* * *

[1] See e.g. "Oregon Death with Dignity Act Attending Physician Follow-up Form," question 15, providing seven suggested answers as to why there was a lethal dose request. Some of the answers are written in terms of disability being an acceptable reason to kill yourself. These answers include: "[A] concern about . . . the loss of control of bodily functions."